standard-title FAQ FOR PARENTS > 41-50 Frequently Asked Questions - For Parents

FAQ FOR PARENTS > 41-50

Frequently Asked Questions - For Parents

Frequently Asked Questions (FAQ)

Questions and answers about Hypospadias.

41. Why you do NOT recommend and do NOT perform the TIP technique although many surgeons are still doing it?

About one third of patients referred to the Hypospadias Centre had a failed TIP procedure. The concept of the TIP procedure results in leaving a large raw surface in the reconstructed urethra. This raw surface usually contracts during healing resulting in a very narrow urethra and persistent fistula. Occasionally, the whole wound disrupts completely and urine comes out from the original opening. The condition becomes more complicated when the surgeon during the TIP procedure has excised the forskin. This makes the job of correction more difficult as there is no excess skin available to reconstruct the narrow urethra.

 
Pin point meatus after TIPmore urine from fistula

42. After I leave the hospital, when should I be worried and call the surgeon?

We tell the parents not to look at the penis for one month after surgery until the swelling disappear and the wound has healed by 70%.

However, the mother should contact the surgeon when the child has severe pain or difficulty to pass urine or can not passs urine for more than 6 hours.

43. After I leave the hospital, when should I go to my routine pediatrician?

Normally, there is no need to go to your pediatrician regarding the operation. If there is real worry, you need to contact your surgeon.

However, if your son develops fever or other complaints not related to the operation, you should go to your pediatrician as is usually the case..

44. If my son develops fever after hospital discharge, is this related to the hypospadias operation?

If your son has no (or little) pain when passing urine and the wound is not very swollen and red, it is almost certain that the fever has nothing to do with the hypospadias operation and you should contact your pediatrician to exclude flu, chest infection, teething…etc.

45. What happens with the sutures and threads after surgery? Do they need to be removed?

Professor Hadidi uses very fine absorbable sutures (finer than the human hair) and they dissolve spontaneously between 1-3 months after surgery and there is no need to remove them. However, some of the threads may take longer than that in some patients. This is normal and should not alarm the parents or the patient. It is important not to try to pull them out, as this may interfere with the healing.

46. I have noticed that my son penis became red 3-4 weeks after hospital discharge and he has some pain when he passess urine is this normal?

As mentioned above, the sutures start to dissolve about one month after surgery. They dissolve by having a chemical reaction. When this occurs, the penis may become red, swollen and small yellow “pustules” may appear. This is all normal and will disappear within a week without leaving a trace.

Small pustules during the absorption of sutures 3-4 weeks after surgery:

47. How long does it take for the hypospadias repair to heal and what are the precautions?

It takes one month for the wound to heal by 70 % and 6 months to heal by 100 %. This is why any further surgery should be planned 6 months after the last surgery.

This means that we should avoid any trauma to the penis for one month, use 2 pampers of sport protection for one month. Also: swimming, bathing, sport should be postponed for one month after surgery

After one month, the wound is stable and the child can lead a completely normal life (please note, that for ad

However, complete healing takes about 6 months after surgery.

48. Will the new urethra grow normally with the penis as my son grows?

The new urethra is made of your son own skin and fascia with normal blood vessels. It will grow normally as your son grows.

49. When should post operative examinations take place and for how long?

Our standard protocol is that the parents send an e-mail one month after surgery to report how is the healing of the operation. The first routine post.operative examination is 3 month after surgery by the operating surgeon (Professor Hadidi). We recommend to maintain regular follow up after 1, then 2, then every 3 years until puberty.

50. What is a fistula, does this require surgical correction?

“My son had surgery for his hypospadias few weeks ago. Everything looked very nice untill the surgeon removed the catheter from his penis. I noticed that gradually less urine is coming out from the tip of the pensi and urine is coming out from another opening near where the original urine opening was. What is this ? Is this a fistula?”

Fistula is a tract or tunnel connecting between the urethra and the skin. Through this tunnel, urine comes out. The parents can recognise this easily when they see that urine comes out through more than one opening when the child is passing urine more than a month after surgery. During the first month after surgery, the wound has not healed and it is normal that urine may come out in between the sutures. The fistula may be single or multiple ( the parents may notice more than two streams of urine). The fistula normally appear1 – 4 months after surgery. In about 5 % of cases. Fistula may appear years after surgery due to reaction to suture materials remaining in the penis after complete healing of wound.

Fistula after hypospadias repair:

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